Characterization of Malignant Portal Vein Thrombosis with Contrast Enhanced Ultrasonography

January, 2019 — Ultrasound in Medicine and Biology

Abstract

We prospectively evaluated the effectiveness of contrast-enhanced ultrasonography (CEUS) for differentiation of benign versus malignant portal vein thrombosis (PVT). We studied a total of 43 patients with chronic liver disease, hepatocellular carcinoma-suggestive nodules and confirmed PVT, in whom the nature of the PVT was confirmed by follow-up imaging (US, computed tomography and/or magnetic resonance imaging) performed up to 6 mo after CEUS. PVT was assessed by US, Doppler US and CEUS with respect to vessel wall disruption and/or invasion, color Doppler vascularization, pulsed Doppler vascularization pattern and CEUS enhancement and vascularization pattern, and thrombi were classified as benign or malignant based on these findings. Follow-up studies revealed malignant PVT in 22 of the 43 patients (51%) and benign PVT in 21 patients (49%). CEUS findings were consistent with follow-up studies in 41 of the 43 patients (95%), with κ = 0.903 (p < 0.0001), sensitivity = 91% and specificity = 100%, indicating that CEUS can be confidently used to differentiate benign from malignant portal vein thrombosis in the setting of chronic liver disease.

Authors; Maria C. Chammas; Andre C. Oliveira; Mario J D´Ávilla; Pedro H. Moraes; Marcelo Straus Takahashi

Ultrasound Division, Department of Radiology, Hospital das Clınicas, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; and Liver Surgery Division, Department of Surgery, Hospital das Clınicas, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil

January 2019, Volume 45, Issue1, Pages 50–55